USAR and ARNG have the option of entering an event voucher in the Army’s Automated Voucher System (AVS). All other branches should contact the IMR Department at RHRP at 1-800-666-2833, ext 3508 for assistance.

Individual vouchers must be submitted through AVS for USAR and ARNG. All other branches should contact their command for further guidance on how to submit a voucher. To cancel a voucher, contact RHRP Customer Service at 1-800-666-2833 ext. 3555.

Group events must be submitted through AVS for USAR and ARNG. All other branches should contact their command for further guidance on how to request a group event. To cancel a group event, contact your event coordinator or contact IMR at 1-800-666-2833, ext 3508.

First, complete the Service member portion of the PDHRA on your Service-specific website. Then, call the toll free PDHRA call center, which is available 24 hours a day / 7 days a week at 1-888-734-7299, option 3.

For USAR only, and only for an in-clinic appointment: you need to start the process on your AKO site. Complete the Service member portion and call Customer Service at 1-888-697-4299 to schedule the face-to-face appointment. If you are having problems accessing your AKO site, call the number above and complete the Service member portion over the phone.

If you are getting your PHA at a group event, you should not complete the AKO portion of the PHA as this information will be obtained at the event.

A Comprehensive Audio Evaluation (CAE) is more than just an audiogram and is used to determine the hearing portion of the PULHES when a possible loss of hearing has been identified. The CAE includes a bone-density screening and can also include a SPeech Recognition In Noise Test (SPRINT) if needed.

RHRP will send (by Federal Express) a package of paperwork and/or supplies to you prior to your appointment. Please review and complete all necessary paperwork before the scheduled appointment and bring all materials with you. Also bring any relevant medical documentation (i.e., MRB, profiles, etc.) and your prescription eyeglasses if attending a PHA.

If you have documentation to show you’ve had the service, you should make a copy and give it to the provider. If you just don’t want the service or are unsure if you need the service, you should contact your Command’s IMR representative for guidance before refusing the service, as there may be repercussions with your command for doing so.

Reserve Health Readiness Program: DoD Civilian

View questions and answsers about the Reserve Health Readiness Program (RHRP) for DoD Civilians:

You can view your health record on the TOL Patient Portal through the Blue Button feature. If something’s missing, contact the provider that conducted the exam or ordered the lab work to ensure it gets added. All your health records are shared with the VA.

You can file a VA disability claim through eBenefits, in person with a Veterans Service Organization, or with a VA representative at a military installation. Submit a copy of your Service Treatment Record (STR) from your current period of military service and any copies of private treatment records not associated with TRICARE referrals. For more information on VA disability benefits, call 1-800-827-1000 or visit the VA’s website.

Small Business Programs

View questions and answers about the Defense Health Agency Small Business Program.

TEAM UP

Facilities that have used TEAM UP have first gathered support from the internal staff team around asking patients to engage in their care, and specifically around the concepts highlighted within the TEAM UP brochure. Once you have secured the support from your colleagues, begin to share the brochures with your patients – to officially welcome them onto the care team!

Third Party Collection Program

Other health insurance (OHI) is any health insurance policy covering medical, dental, or pharmacy that you may have through your employer or private insurance company. TRICARE, TRICARE Supplemental plans, Medicare, Medicaid, and certain government-sponsored programs are not OHI. If you have OHI and are covered by TRICARE, federal law requires military treatment facilities (MTFs) to collect reasonable payments from third party payers (unless you are active duty). The money collected (commonly referred to as “reimbursement” or “remittance”) supports the operation and maintenance budget of the MTF where you receive your care. OHI reimbursements help your MTF improve the quality of health care.

At every visit, you are required to inform DoD about any OHI you have or any changes since your last appointment. A DD Form 2569 must be completed annually and when your insurance coverage or information changes. Health plan information (see below) can change between appointments and from year to year. Please verify that you have the most up-to-date health insurance information from your insurance provider and report it on the DD Form 2569. Some MTFs utilize DD Form 2569 Compliance Cards that allow beneficiaries to certify the form has been completed. Beneficiaries must still update the DD Form 2569 with any changes and renew their OHI registration card, generally upon the anniversary of the issue date noted on the card or when OHI status or information is updated.

No. You will not be billed for care at an MTF (except for subsistence costs related to inpatient care or co-pays for TRICARE services provided downtown). In every case in which payment from a third party payer is received, it will be considered as satisfying the normal medical services or subsistence charges, and you will not have to make any further payment.

Your provider can either call the Express-Scripts prior authorization line @ 1-866-684-4488 or he/she can fill out the prior auth form that is linked to that medication on the Formulary Search Tool and fax it to Express-Scripts.

Your provider can either call the Express-Scripts prior authorization line @ 1-866-684-4488 to establish medical necessity or he/she can fill out the medical necessity form that is linked to that medication on the Formulary Search Tool and fax it to Express-Scripts.

For the pilot, if either the civilian facility or the MTF makes the request, it is considered an "order" and allows TRICARE to cost share for the ambulance transport to the MTF. >>View Health Plan Costs

In some locations, the MTF may arrange for a contracted ambulance service at no cost to the beneficiary.

Uniform Business Office

This FAQ section is updated with questions the UBO gets about the Military Health System's (MHS’s) three health care cost recovery programs and overall revenue cycle direction.

You should contact the payer and ask for the reason(s) that the claim was denied and what information is necessary to correct the claim (make sure you document the conversation). In addition to reviewing on a claim by claim basis, review denials for trends for certain submissions. Talk with your utilization review team to get a sense as to what is impacting covered vs. non-covered claims, identify trends, and seek to proactively reduce and correct common mistakes.

For additional questions or comments, please email the UBO Help Desk, or leave a message for the Help Desk staff at 202-741-1532.

Yes, MTFs can bill for acupuncture and chiropractic services, provided there are UBO approved rates for the services (CPT or HCPCS codes). However, the payer may not cover acupuncture and chiropractic services if the payer determines those services are not covered, unless they are deemed medically appropriate by the provider.

Virtual Lifetime Electronic Record Health Information Exchange

Questions and answers about the Virtual Lifetime Electronic Record Health Information Exchange

The eHealth Exchange is a rapidly growing health information exchange network for securely sharing clinical information over the Internet nationwide. It is the largest health information exchange infrastructure in the United States (U.S.). Current eHealth Exchange participants include large provider networks, hospitals, pharmacies, regional health information exchanges and many federal agencies, representing 40% of all U.S. hospitals, tens of thousands of medical groups, more than 8,000 pharmacies and 100 million patients.

HIE protects the privacy and security of your health care information by following the rules set in the Health Insurance Portability and Accountability Act (HIPAA) of 1996. The HIPAA Privacy Rule provides federal protections for individually identifiable health information and gives patients’ rights about that information. The Privacy Rule permits the sharing of health information for patient care and other important purposes. The Security Rule lists administrative, physical, and technical safeguards that must be used to protect the privacy and security of your health care information.

Access to your medical history is very important to the health care providers caring for you. Using eHealth Exchange, your health care providers have a more complete view of your health record. This allows you and your health care team to make informed decisions about your health. Through the eHealth Exchange, your health care providers can share information on your prescriptions and medications, allergies, illnesses, laboratory and radiology results, immunizations, procedures, and clinical notes*.

*To improve your care experience, health information may be shared as permitted by the Health Insurance Portability and Accountability Act (HIPAA) with other authorized organizations who partner with the MHS. To enhance coordination among care teams, this includes notes written by your clinicians, which could contain information about sexual assault, domestic violence, child/elder abuse, substance abuse, mental health, and sexually transmitted diseases.

If you choose to opt out, the Military Health System (MHS) will not be allowed to electronically share your health care information through the eHealth Exchange for any reason, even in case of emergency where you may be unconscious. Your provider may not have the necessary information to save your life.

A patient can request to opt back in at any time by submitting a VLER HIE Opt Back In Letter. When you opt back in, you allow your health care providers access to important health care information about you when you visit a medical facility connected with the eHealth Exchange and participating with the MHS.

If you have opted out, in the case of an emergency where you may be unconscious, your health care providers may not have immediate and complete access to important health care information necessary to save your life.

No, due to medical readiness and DoDI 6040.45 Active Duty are not able to opt out of VLER HIE.

Warfare Exposure

The Department of Defense (DoD) and the Department of Veterans Affairs (VA) play distinct roles dealing with chemical and biological (CB) exposures. DoD identifies and validates veteran’s exposure to CB agents and provides the names of individuals along with their exposure information to the VA. The VA then notifies individuals of their potential exposure, provides treatment, if necessary, for these individuals and adjudicates any claim for compensation.

In 1993, Deputy Secretary of Defense William Perry issued a memorandum on "Chemical Weapons Research Programs Using Human Test Subjects." The memorandum released "any individuals who participated in testing, production, transportation or storage associated with any chemical weapons research conducted prior to 1968 from any non-disclosure restrictions or written or oral prohibitions (e.g., oaths of secrecy) that may have been placed on them concerning their possible exposure to any chemical weapons agents."

Secretary Perry also directed the Services to initiate procedures to release individuals who participated in testing, production, transportation or storage associated with any chemical weapons research after 1968 from any non-disclosure restrictions that may have been placed on them. Since most information relating to this research has been declassified, at least in part, Force Health Protection and Readiness has determined that participants in chemical-related research after 1968 may talk about their individual experiences to the Department of Defense (DoD) or the Department of Veterans Affairs without violating their oath of secrecy.

DoD maintains a Project 112/SHAD (Shipboard Hazard and Defense) database. This database contains the names of veterans who participated in Project 112/SHAD testing in the 1960s and 1970s. It contains 6,400 names and is updated as needed when we discover additional veterans who were part of this testing. DoD also maintains a database containing the names of veterans who participated in mustard agent tests during World War II. The total numbers to date are 6,730. DoD is also currently in the process of populating our third exposure database, the Cold War Exposure database, which numbers 30,726. This database contains the names of veterans not included in other databases who participated in chemical and biological testing since World War II.

If you need help verifying your possible participation in any of the tests or have information about the testing, please call the Department of Defense's contact managers at (800) 497-6261, Monday through Friday, 7:30 a.m. to 4 p.m. EST.

If you'd like to speak with a Veterans Affairs (VA) representative, call the Special Issues Helpline at 1-800-749-8387. Many states offer services and benefits to veterans. To find out more about a particular state, please visit the VA State Veterans Affairs page.

The Department of Defense (DoD) has identified over 400 substances used during testing. Not all the substances were harmful as DoD tested many medicines and antidotes. These substances may be broken down as follows:

No. Current medical chemical & biological defense programs involving human subjects do not involve the exposure of these subjects to chemical or biological warfare agents.

There are medical chemical & biological defense programs that involve the use of human subjects in controlled clinical trials to test and evaluate the safety and effectiveness, of medical products (drugs, therapies, etc.) to protect against chemical agents. The use of human subjects in these trials involves volunteers who have provided informed consent. All use of human subjects in these trials is in full compliance with the "Common Rule," Federal Policy for the Protection of Human Subjects, Food and Drug Administration (FDA) regulations, Federal Acquisition Regulations (FAR), DoD Directives and Instructions, and all other applicable laws, regulations, issuances, and requirements.

The contractor doing the research for DoD on potential exposures has over 10 years of experience working with potential exposures. This experience enabled them to quickly identify major document storage locations and to prioritize their search efforts. More important is whether or not a storage site catalogued its documents. If a storage site did not catalogue its collection, researchers must comb through all material to locate the small subset that contains exposure information. This slows down the search effort.

Before terminating our efforts to locate potential chemical and biological exposures, DoD will work with its contractor to insure that the contractor did not miss any storage site that potentially contained a significant number of exposures.

West Nile virus is most commonly transmitted to humans by mosquitoes. Additional routes of human infection have also been documented. It is important to note that these methods of transmission represent a very small proportion of cases:

Blood transfusions

Organ transplants

Exposure in a laboratory setting

From mother to baby during pregnancy, delivery, or breastfeeding

West Nile virus is not transmitted:

From person-to-person or from animal-to-person through casual contact. Normal veterinary infection control precautions should be followed when caring for a horse suspected to have this or any viral infection.

From handling live or dead infected birds. You should avoid bare-handed contact when handling any dead animal. If you are disposing of a dead bird, use gloves or double plastic bags to place the carcass in a garbage can.

Through consuming infected birds or animals. In keeping with overall public health practice, and due to the risk of known food-borne pathogens, always follow procedures for fully cooking meat from either birds or mammals.

No symptoms in most people: Most people (70-80%) who become infected with West Nile virus do not develop any symptoms.

Febrile (fever) illness in some people: About 1 in 5 people who are infected will develop a fever with other symptoms such as headache, body aches, joint pains, vomiting, diarrhea, or rash. Most people with this type of West Nile virus disease recover completely, but fatigue and weakness can last for weeks or months.

Severe symptoms in a few people: Less than 1% of people who are infected will develop a serious neurologic illness such as encephalitis or meningitis (inflammation of the brain or surrounding tissues).

The symptoms of neurologic illness can include headache, high fever, neck stiffness, disorientation, coma, tremors, seizures, or paralysis.

Serious illness can occur in people of any age. However, people over 60 years of age are at the greatest risk for severe disease. People with certain medical conditions, such as cancer, diabetes, hypertension, kidney disease, and people who have received organ transplants, are also at greater risk for serious illness.

Recovery from severe disease may take several weeks or months. Some of the neurologic effects may be permanent.

About 10 percent of people who develop neurologic infection due to West Nile virus will die.

West Nile virus disease cases have been reported from all 48 lower states. The only states that have not reported cases are Alaska and Hawaii. Seasonal outbreaks often occur in local areas that can vary from year to year. The weather, numbers of birds that maintain the virus, numbers of mosquitoes that spread the virus, and human behavior are all factors that can influence when and where outbreaks occur.

Serious illness can occur in people of any age. However, people over 60 years of age are at the greatest risk for severe disease. People with certain medical conditions, such as cancer, diabetes, hypertension, kidney disease, and people who have received organ transplants, are also at greater risk for serious illness.

Zika Virus

The Zika virus is spread primarily through the bite of an infected mosquito. These are the same mosquitoes that spread other viruses like dengue and chikungunya. Only about one in five people infected with the Zika virus will feel sick. In those that do, symptoms are usually mild and can include fever, rash, joint pain and red eye.

Many people infected with Zika virus won’t have symptoms or will only have mild symptoms.

The most common symptoms of Zika are fever, rash, joint pain, or conjunctivitis (red eyes).

Other common symptoms include muscle pain and headache.

The illness is usually mild with symptoms lasting for several days to a week.

People usually don’t get sick enough to go to the hospital, and they very rarely die of Zika. For this reason, many people might not realize they have been infected.

The incubation period (the time from exposure to symptoms) for Zika virus disease is not known, but is likely to be a few days to a week. See your doctor or other healthcare provider if you are pregnant and develop a fever, rash, joint pain, or red eyes within 2 weeks after traveling to an area with Zika. Be sure to tell your doctor or other healthcare provider where you traveled.

Zika is primarily spread to people through the bite of infected Aedes mosquitoes. It can also be transmitted from a pregnant mother to her baby during pregnancy, though we do not know how often that transmission occurs.

People are contracting Zika in areas where Aedes mosquitoes are present, which include South America, Central America and the Caribbean. As the CDC notes, specific areas where the Zika virus is being transmitted are likely to change over time, so please check the CDC website for the most updated information.

There may be a link between a serious birth defect called microcephaly—a condition in which a baby's head is smaller than expected—and other poor pregnancy outcomes and a Zika infection in a mother during pregnancy. While the link between Zika and these outcomes is being investigated the CDC recommends that you take special precautions if you fall into one of these groups:

If you are pregnant (in any trimester):

You should consider postponing travel to any area where the Zika virus is active.

If you must travel to an active region, talk to your doctor first and follow the steps to prevent mosquito bites during your trip.

If you are trying to become pregnant:

Before you travel, talk to your doctor about your plans to become pregnant and the risks posed from infection.

Families of newborns affected by Zika virus (Zika) may be overwhelmed, worried, and unsure of next steps in caring for their baby. A baby affected by Zika virus may be born with significant health issues, like microcephaly. Others may not have apparent symptoms at birth, but may develop them over time.

The Florida Department of Health has identified two areas of Miami-Dade County where Zika is being spread by mosquitoes. In addition to the previously identified area in the Wynwood neighborhood, there is now mosquito-borne spread of Zika virus in a section of Miami Beach. >>Learn More

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